Quiles Juan, García-Fernández Miguel A, Avanzas Pablo, Martínez-Sellés Manuel, Rosas Rafael, Sánchez Hernández Ana, Moreno Mar, Bermejo Javier, Pérez-David Esther
Laboratorio de Cardiología No Invasiva. Servicio de Cardiología. Hospital General Universitario Gregorio Marañón. Madrid. España.
Rev Esp Cardiol. 2003 May;56(5):480-6. doi: 10.1016/s0300-8932(03)76903-6.
The latest development in echocardiography is the hand-held ultrasound device. Previous studies have shown that portable ultrasound devices detect major cardiovascular pathology better than the physical examination, but their diagnostic accuracy is still not known. The purpose of this study was to compare the results of examinations made with portable devices to those obtained with higher-scale platforms.
211 consecutive unselected patients were included in the study. Patients were randomly studied with a portable device and a standard platform (considered the gold standard for comparison) by cardiologists experienced in echocardiography. Parameters of cardiac morphology and function, and valvular regurgitation were compared and analyzed using the McNemar paired test. Differences of more than one grade were considered major differences.
The subjective assessment of the studies made with the portable device was significantly worse. The correlation between estimates of left ventricular function (differences not statistically significant) was adequate, but significant differences were detected in the evaluation of left atrial enlargement, left ventricular hypertrophy, aortic root enlargement, and mitral and tricuspid regurgitation.
Hand-held cardiac ultrasound devices do not satisfy criteria for a complete echocardiographic study. They provide accurate information about ventricular function but fail to adequately measure cardiac chambers or assess valve function.
超声心动图的最新进展是手持式超声设备。先前的研究表明,便携式超声设备在检测主要心血管病变方面比体格检查更具优势,但其诊断准确性仍不明确。本研究的目的是比较便携式设备与更高端平台的检查结果。
本研究纳入了211例未经挑选的连续患者。由经验丰富的超声心动图心脏病专家使用便携式设备和标准平台(被视为比较的金标准)对患者进行随机研究。使用McNemar配对检验比较并分析心脏形态和功能参数以及瓣膜反流情况。超过一级的差异被视为主要差异。
使用便携式设备进行的研究主观评估明显较差。左心室功能评估之间的相关性(差异无统计学意义)尚可,但在左心房扩大、左心室肥厚、主动脉根部扩大以及二尖瓣和三尖瓣反流的评估中发现了显著差异。
手持式心脏超声设备不符合完整超声心动图检查的标准。它们能提供有关心室功能的准确信息,但无法充分测量心腔或评估瓣膜功能。